Early Ventricular Arrhythmias after Left Ventricular Assist Device Implantation.
Ventricular tachycardia
left ventricular assist device
ventricular fibrillation
Journal
Journal of cardiac failure
ISSN: 1532-8414
Titre abrégé: J Card Fail
Pays: United States
ID NLM: 9442138
Informations de publication
Date de publication:
14 Dec 2023
14 Dec 2023
Historique:
received:
01
09
2023
revised:
14
11
2023
accepted:
14
11
2023
medline:
17
12
2023
pubmed:
17
12
2023
entrez:
16
12
2023
Statut:
aheadofprint
Résumé
While sustained ventricular arrhythmias are a common complication following durable left ventricular assist device (LVAD) implantation, the incidence, risk factors, and prognostic implications of early postoperative ventricular arrhythmias (EVAs) in contemporary LVAD patients are poorly understood. A single-center retrospective analysis was performed of patients who underwent LVAD implantation from 10/1/2006-10/1/2022. EVA was defined as an episode of sustained ventricular arrhythmia identified ≤30 days after LVAD implantation. A total of 789 patients underwent LVAD implantation (age: mean 62.9 years ± 0.5, HeartMate 3: 41.4%, destination therapy: 43.3%). EVAs occurred in 100 (12.7%) patients. A history of ESRD (OR 5.6, CI 1.45-21.70), preoperative electrical storm (OR 2.82, CI 1.11-7.16) and appropriate ICD therapy prior to implantation (OR 2.8, CI 1.26-6.19) are independently associated with EVAs. EVA was associated with decreased 30-day survival (HR 3.02; 1.1-8.3 95% CI; p = 0.032). There was no difference in transplant-free survival time between patients with and without EVAs (HR 0.82; 0.5-1.4 95% CI; p = 0.454). EVAs are common after durable LVAD implantation and are associated with increased risk of 30-day mortality.
Sections du résumé
BACKGROUND
BACKGROUND
While sustained ventricular arrhythmias are a common complication following durable left ventricular assist device (LVAD) implantation, the incidence, risk factors, and prognostic implications of early postoperative ventricular arrhythmias (EVAs) in contemporary LVAD patients are poorly understood.
METHODS
METHODS
A single-center retrospective analysis was performed of patients who underwent LVAD implantation from 10/1/2006-10/1/2022. EVA was defined as an episode of sustained ventricular arrhythmia identified ≤30 days after LVAD implantation.
RESULTS
RESULTS
A total of 789 patients underwent LVAD implantation (age: mean 62.9 years ± 0.5, HeartMate 3: 41.4%, destination therapy: 43.3%). EVAs occurred in 100 (12.7%) patients. A history of ESRD (OR 5.6, CI 1.45-21.70), preoperative electrical storm (OR 2.82, CI 1.11-7.16) and appropriate ICD therapy prior to implantation (OR 2.8, CI 1.26-6.19) are independently associated with EVAs. EVA was associated with decreased 30-day survival (HR 3.02; 1.1-8.3 95% CI; p = 0.032). There was no difference in transplant-free survival time between patients with and without EVAs (HR 0.82; 0.5-1.4 95% CI; p = 0.454).
CONCLUSION
CONCLUSIONS
EVAs are common after durable LVAD implantation and are associated with increased risk of 30-day mortality.
Identifiants
pubmed: 38103723
pii: S1071-9164(23)00912-0
doi: 10.1016/j.cardfail.2023.11.018
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2023. Published by Elsevier Inc.
Déclaration de conflit d'intérêts
Conflict of Interest Farooq H. Sheikh: Abbott: Institutional research support and honorarium for speaking at educational conferences. No company or agency had any role in this manuscript.